Here are 11 things people struggling with infertility want you to know:

1) Being infertile is tough.

Every day, we think about how we want to get pregnant but aren’t able.

2) Other people’s pregnancies hurt.

Just being honest here. It’s painful when someone announces they’re pregnant. We don’t want to take away your happiness, so don’t be afraid to share the good news. But yes, it’s difficult for us.

3) Saying “You’re lucky not to have kids” doesn’t make us feel better.

We know our lives will change drastically if we have kids. You may think that making your blessing sound like a curse would make us feel better. It doesn’t.

4) Don’t say, “Worse things could happen.”

To a couple who just wants to love and nurture a child, infertility is definitely the worst thing that could happen.

5) Being young doesn’t always mean we have plenty of time to get pregnant.

It’s simply not always true. Infertility.About.com gives this example: for a woman with premature ovarian failure, time is not on her side. The longer she waits, the more likely she will need an egg donor. Commenting on age is dismissive and unhelpful.

6) Don’t tell us success stories.

We’re well-educated on statistics and success rates. We see specialists, and monitor ovulation, sperm count and hormone levels. So those tales of someone else’s success make us feel inferior. Besides, success stories don’t make us hopeful, they make us feel worse.

7) Don’t say, “Just relax.”

How can we relax when we can’t control the one thing we want more than anything? Infertile people aren’t just stressed-out and in need of relaxing. There is so much more to conception than that.

8) We don’t believe that “Everything happens for a reason.

Please don’t say that. We’re constantly asking ourselves why it isn’t happening. We know you may think it is a kind comment, but it’s not.

9) Don’t ask about IVF.

In vitro fertilization is not the cure-all for infertility. IVF is rarely covered by insurance and very expensive. One treatment cycle can cost between $12,000 and $25,000.

To be successful, many treatment cycles may be needed. Furthermore for women under 35, there’s a less than 40-percent-per-cycle success rate, according to Infertility.About.com.

10) We know adoption is an option.

Mentioning adoption ignores our feelings about wanting our own flesh-and-blood child. Not to mention the financial costs of adoption. There’s a lot involved in adopting a child. And it doesn’t just happen.

11) It hurts when people say, “Maybe you’re just not meant to be parents.”

No one knows why infertility happens to some people and not to others. Don’t pretend to know why we haven’t conceived.

Sandra and Gavin McSweeney tell our reporter about the unexpected joy of conceiving not once but twice via IVF

Anyone who has been through it, will tell you that IVF can be tough. There are the frequent doctor’s appointments, the injections, the procedures, the scans, the nerves, the hopes and often the disappointments. There’s the financial cost, the stress and the strain it can put on a relationship.

But then anyone who has been through it and held their baby at the end of it will tell you it was worth it. Not all of them, though, will want to go through it all again.

And yet Sandra McSweeney’s story is proof that happy endings can happen twice. The 38-year-old from Ballygarvan, Co Cork can still remember that aching feeling of longing she felt when she and her husband Gavin (38) were trying to conceive.

“I felt like there were babies and buggies everywhere,” she recalls. “I remember looking longingly at bumps. It was very difficult but at the same time I wouldn’t have wished it on anyone, it’s devastating not to be able to have children when you desperately want to have one.”

When she was 27 years old Sandra was diagnosed with Endometriosis, a condition affecting the lining of the womb. She needed surgery to have a painful cyst removed, but the procedure revealed how damaged her womb was and one of her fallopian tubes had to be tied.

“I was advised that it might cause fertility problems, but I didn’t really think about it too much,” she says. “At the time I felt I had time on my side and I remember thinking, ‘well, hopefully it’ll happen’.”

Unfortunately hope wasn’t enough. Despite changes to her diet and trying acupuncture, Sandra’s condition left her unable to conceive naturally. “It was devastating but we had to say ‘ok, what other options have we?’,” she says. “Thankfully Gavin and I were on the same page. We really wanted a baby and we wanted to give it our all to be parents but we also knew that we didn’t want it to consume our lives and destroy our relationship.”

In July 2011 they started In Vitro Fertilisation (IVF) treatment with the Waterstone Clinic. The process is one of the most popular routes taken by couples battling conception difficulties. Daily injections of medication are used to stimulate the ovaries to produce a number of eggs which are then collected and mixed with the male’s sperm in the laboratory, allowing fertilisation to occur.

“The developing embryos are then monitored closely and the healthiest embryos are then transferred to allow for implantation,” explains Dr Tim Dineen, Head of Laboratory Services at Waterstone Clinic. “There are several stages and the average treatment cycle takes approximately eight weeks from the start of medication until a pregnancy test is taken.”

Sandra’s first cycle was cancelled early on because she had no follicles to produce eggs for collection. Their second cycle also ended prematurely when they were told there were no eggs.

“It was very upsetting,” says Sandra. “Maybe we were a bit naïve but we felt like making the decision to start treatment had been the big thing, we weren’t really prepared for set-backs.”

And yet some statistics would suggest that only about 20-30 percent of IVF treatments lead to conception, with other factors like age also playing a part. Interestingly there is no official data available in Ireland for how many babies are born through IVF. Unlike the UK and USA, the State has no formal reporting procedure, something the fertility clinics here are seeking to change so patients can have access to transparent information on success rates.

With WHO statistics finding that one in five Irish people has some difficulty with fertility, it seems safe to assume that a growing number of people are choosing to go down the route of medical assistance, even if they’re not talking about it.

Sandra and Gavin decided to be open with friends and family from the start. “We wanted to talk about it and we found that the more we spoke to people, the more we realised how many other couples we knew had gone through similar experiences,” says Sandra.

“There’s definitely a taboo there, even when we went to the clinic for appointments there would have been a lot of eyes on the ground, no one wants to make eye contact in case they see someone they know!

“But our attitude always was that if this was something that, if it helped us, then it was amazing, but definitely not something to be ashamed of and I don’t know if we would have got through it if it hadn’t been for the support of our friends and family.”

On their third attempt, in March 2013, the couple completed a full cycle of treatment and Sandra was given a date to take a pregnancy test. After counting down for two weeks, the result was devastating: negative.

“We had to leave it for a while after that, just to get our heads around it, but I still knew that I really, really wanted to give it one more shot,” remembers Sandra. “We went back and were advised that maybe IVF wasn’t going to work for us and we might have to look at other options like egg donation.”

But just over nine months later, and weighing a healthy 8lbs 2oz, baby Maisey was born.

She arrived just eight weeks after the death of Sandra’s mother, and whilst she provided a light at a dark time, it was heartbreaking they never got to meet. Emotionally and financially both Sandra and Gavin’s parents had been a vital source of support. A full cycle of IVF costs in the region of €5,000 with incomplete cycles a fraction of that cost depending on what stage of the process is reached. They were, says Sandra, “extremely lucky” our parents helped us out with money.

Which was one of the considerations they had to factor in when they decided to try for another child.

“I’m from a family of five and there are four in Gavin’s family and we all live in Cork and are very close,” explains Sandra. “I really wanted Maisey to have a sibling and I knew from the point of view of my age, the clock was ticking.

“But at the same time it felt a little bit greedy. We’d already been so unbelievably lucky to have our first baby. There are only so many favours you can ask for and it’s hard to say, ‘would you mind funding this again?’ when the goal had been to have a child, which we did.”

She doesn’t know if they would have tried as many cycles again, but happily it’s not a question that needs answered – after the first round of treatment she was pregnant with their son Joey.

According to Dr Dineen, the fact that Sandra had already had a baby was a good prognosis for delivering a second child, nor did embarking on the treatment plan again come with any additional risk.

Sandra wants to pay tribute to the staff at Waterstone Clinic and reassure other would-be mums. “I hope our story might give hope to somebody who is considering IVF and maybe a bit scared,” she says.

Some nights she finds herself staring down at Maisey, who will be three next month, and 10-month-old Joey as they sleep.

“I just find myself reflecting on how unbelievably grateful I am,” she says. “Every baby is precious but they are definitely extra special to us. I tell them they’re my magic beans, they’re our little miracles.”

Advice for couples considering IVF

Research and review your choice of clinic asking questions about services offered, success rates, inspection records and any hidden costs. “Ideally you want to avoid long journeys as a number of visits to the clinic will be required for scans and having a local clinic will eliminate the stress and cost of travelling,” says Dr Tim Dineen, Head of Laboratory Services at Waterstone Clinic.

Ensure you fully understand your treatment plan and are aware of any possible side-effects.

Decide in advance whether to tell family and friends.

“It’s important to look after your relationship during treatment,” says Dr Dineen. “Complimentary counselling is available at Waterstone Clinic and patients are encouraged to avail of this service.”

Look after your health. “Start taking folic acid, engage in regular exercise (but nothing too vigorous), eat as healthily as possible and most certainly, stop smoking,” advises Dr Dineen.

Chrissie Russell, Irish Independent

http://www.independent.ie/life/family/family-features/irish-couples-unexpected-joy-as-they-conceive-twice-with-ivf-i-tell-my-babies-that-theyre-my-little-miracles-34605328.html

Cystic Fibrosis Ireland Annual Conference 2016 will take place from Friday 8th – Sunday 10th April 2016, in the Clarion Hotel Sligo. Dr. Tim Dineen, Head of Laboratory Services at Waterstone Clinic is delighted to attend the event as a guest speaker and will discuss “Reproductive Health – Management & Treatment in Cystic Fibrosis” at 11.30 on Saturday April 9th.

Cystic Fibrosis is a genetically inherited disease that primarily affects the lungs and the digestive system. Ireland has the highest incidence of Cystic Fibrosis in the world – approximately 1 in 19 Irish people are said to ‘carry’ one copy of the altered gene that causes Cystic Fibrosis.

6 am

I am head of the laboratory at Waterstone Clinic. My main role involves the fertilisation of eggs through in vitro fertilisation (IVF). In traditional IVF, with normal sperm count and motile sperm, we add the sperm to eggs and let nature take its course. We then check the eggs have been fertilised the following day.

When dealing with low sperm numbers or poor motility there is a higher chance fertilisation will not occur, so we use intracytoplasmic sperm injection (ICSI). This allows us to inject a single sperm into each egg. Selecting the eggs for ICSI is straightforward in that we only inject mature eggs, as an immature one does not have the potential to fertilise. The sperm, which has already gone through a selection process when it was prepared, is added to a viscous medium to slow it down and capture a healthy sperm.

We use high-powered microscopes with micro-manipulators to keep the egg in place while the sperm is injected — the eggs are smaller than a speck of dust.

ICSI has revolutionised IVF treatment as it allows us to overcome many forms of male fertility problems. Even when there is no sperm in the ejaculate, it’s not the end of the line: we can perform a biopsy to retrieve sperm from the testes, and use that to create embryos.

This is one of only two IVF clinics in Ireland authorised to carry out embryo biopsy to facilitate preimplantation genetic diagnosis (PGD) and preimplantation genetic screening (PGS). For PGD, this gives a couple the option of trying to reduce the risk of passing on a genetic condition.

We only recommend PGD treatment for couples where a life-limiting condition has been identified and will be passed on to their children. We do not use the treatment for “designer babies”.

There are a number of rare single-gene conditions we get inquiries about, but the one we are asked to test for most in relation to PGD is cystic fibrosis. Ireland has one of the highest carrier rates of cystic fibrosis in the world.

Our first couple for PGD involved a man affected with cystic fibrosis whose partner was a carrier. They had a one in two chance of every pregnancy being affected with the disease. When a couple is faced with this tough decision, they have a number of choices, one of which is to carry out PGD. Alternatively, they could pursue a treatment cycle with donor sperm.

In this case, we had to check if the male was producing sperm: one of the features of cystic fibrosis is that there is no sperm in the ejaculate. Fortunately there was sperm, so we fertilised a number of eggs, and on day three removed one cell from each embryo and sent them to a genetics testing lab in the UK. Forty-eight hours later we got the results: there were five embryos suitable for transfer. This meant that while all the embryos were cystic fibrosis carriers, they would not be affected by the condition.

That couple had a healthy baby girl — the ultimate measure of success in PGD.

http://www.thesundaytimes.co.uk/sto/news/ireland/article1672082.ece

Whether actively trying for a baby or planning a family at a later stage in life, reproductive health is hugely important for both men and women. Simple things like lifestyle choices, exercise habits and medical history all play an important role in fertility. Here are 15 ways to become fertility aware, from Mary McAuliffe, Head of Clinical Services at Waterstone Clinic 

1. Educate yourself about the link between age and fertility.

Fertility is age related and knowing how your fertility changes with age is so important, especially for women. Women’s fertility rate begins to decline from age 32, with a more pronounced decline from 35 and a sharp decline from 40 onwards. Men’s sperm can start declining in quantity and quality from 40 years. The key to fulfilling your desire to have a family is to take charge of your reproductive health and plan accordingly.

2. Maintain a healthy weight.

Being underweight or overweight can have a negative impact on fertility for both men and women. If you are actively trying for baby, it’s a good idea to calculate your BMI. Aim for a healthy weight; a BMI of between 20 and 24.9 is ideal. Optimising your weight will help regulate your menstrual cycle and increase your chances of conceiving.  The key message is to get active and engage in an exercise that you enjoy.

3. Eat a healthy and balanced diet.

It’s as important for your fertility health as for your physical health. Maintain a balanced diet with plenty of fresh fruit and veg., avoid processed foods, junk food and fizzy drinks and reduce your caffeine intake as much as possible.  Omega 3 essential fatty acids found in fish oils and good-quality flaxseed oils are not only recommended for healthy cell development, but also play an important role during pregnancy

4. Quit smoking.

As well as being beneficial for your overall health, research shows that it takes longer for smokers than non-smokers to become pregnant. Smoking can cause damage to the ovaries and fallopian tubes and alter the hormone levels required for pregnancy. Smoking also increases the risk of miscarriage within the first 12 weeks of pregnancy. Men who smoke have a lower sperm count that those who don’t and there is some association with increased sperm DNA damage.

5. Reduce alcohol intake.

Heavy alcohol intake in men has been linked to reduced testosterone production and reduced sperm quality. It has also been linked to ovulatory problems in women. It is not known how much alcohol you need to drink before fertility is affected, so it is best to reduce alcohol intake or try to cut it out completely while trying to conceive.

6. Folic acid.

Women should start taking 400mcg folic acid before trying to conceive and during the first three months of pregnancy. Folate is an essential ingredient in cell division and a baby starts out as a single cell that divides again and again. It can also be beneficial for men to take folic acid while trying to conceive. Taking a folic acid supplement can help improve sperm quality and reduce sperm abnormalities.  Foods rich in folic acid include spinach, brussels sprouts, asparagus and avocado.

7. Up your supplements.

Increase your Vitamin D intake; this is important for bone health and also for normal embryo development. Vitamin C and CoQ10 are beneficial for healthy egg and sperm development.

8. Understand your fertile period – especially after time on the pill. 

Take note of your menstrual cycle; keep a record so that you have a good understanding of your cycle length. For example, when women stop taking the contraceptive pill, it can take a while for menstruation to regulate. so it is especially important to stay tuned into any changes. Usually, ovulation occurs on day 14 of a 28 day cycle, so your best chance of becoming pregnant is between day 12 and day 16, sometimes known as the fertile window.

9. Chat to your Mum.

Ask your mum when she started the menopause as this can give you a good indication of when you may expect to start. If your Mum had early menopause, then you should be aware that this may narrow your fertility window.

10. Get to grips with your medical history.

For women who have had surgery for problems such as appendicitis or removal of an ovarian cyst, becoming pregnant can be more challenging as the surgery can sometimes cause blockages in the fallopian tubes. If you have had any medical concerns, or have a history of a sexually transmitted disease, book yourself in for a quick fertility assessment to see if there are any issues you may need to address. Men who have had surgery for undescended testes, have had mumps (this can affect sperm production) or trauma to the groin region, should seek an early fertility assessment.

11. Keep it cool.

It is important not to overheat sperm. Avoid resting laptops on your lap, using heated car seats and keeping your mobile phone in your pocket. Avoid wearing too-tight underwear or jeans for prolonged periods.

12. Don’t over-exercise.

If you are trying to conceive, avoid vigorous exercise or long cycles as these activities can compress or potentially overheat the testicles.  Also avoid hot baths, saunas and Jacuzzis as they can temporarily decrease sperm production.

13. Get amorous.

New research from Indiana University suggests that the more times a woman has intercourse outside of her fertile window, the more her immune system is primed for pregnancy when she has intercourse while ovulating. While this research is novel (September 2015), it is recommended to have intercourse two to three times per week when trying to conceive. Take care of your relationship, communicate with one another and remember to have sex for fun!

14. Don’t stress out.

Take time out to listen to relaxing music, meet with friends or download apps for mindfulness to keep those stress levels in check.

15. Take a positive approach, book a fertility assessment.

It’s becoming ever more convenient to have a fertility assessment. Self-referral services where you book online or over the phone are hassle free and fertility centres will usually offer a discounted rate for a couple having a fertility assessment together. Ensure that you always discuss your results with a fertility expert.

The Minister for Health has announced plans to fund fertility treatment in conjunction with envisaged legislation. The aim is to provide public funding for assisted human reproductive (AHR) treatment in conjunction with the introduction of legislation in this area.

While fertility treatment is not now provided in the Irish public health service, financial support is available to individuals. For example, tax relief for medical expenses and the cost of certain approved fertility medicines are covered under the Medical Card or Drugs Payment Scheme (DPS).

Funding for fertility treatment would be considered in tandem with “closing the current legislative gap” in this area of healthcare, said Minister Leo Varadkar. “Fertility treatments should be funded in such a way that not only maximises efficiency but that ensures equity of access as well,” said the Minister.

“Nevertheless, the provision of public funding for assisted human reproduction must be accompanied by a robust system of legal governance that will promote and protect the health and well-being of patients and most especially the children who will be born as a result of the treatment.”

In February 2015, the Government gave approval to draft a General Scheme of legislative provisions dealing with a broad range of aspects relating to AHR. Drafting is under way and the General Scheme will be published in the first half of 2016.

The aim of the legislation will be to promote and ensure the health and safety of parents, others involved in the process (such as egg/sperm donors and surrogate mothers) and, most importantly, the children who will be born as a result of assisted reproduction.

The Department of Health is commissioning an evidence review of international public funding models. The review will inform policy regarding the optimal mechanism for any future public funding of AHR in the State.

AHR encompasses in vitro fertilisation (IVF), pre-implantation genetic diagnosis, intra-uterine insemination, intra-cytoplasmic sperm injection and gamete donation. Currently, there are a number of fertility clinics operating in Ireland offering a broad range of AHR services, which remains largely unregulated.

Although IVF treatment is not provided by the Irish public health service, there is some support available in that patients who access IVF treatment privately may claim tax relief on the costs involved under the tax relief for medical expenses scheme.

In addition, a defined list of fertility medicines needed for fertility treatment is covered under the High Tech Scheme administered by the HSE. Medicines covered by the High Tech Scheme must be prescribed by a consultant/specialist and approved by the HSE High Tech Liaison Officers. The cost of the medicines is then covered, as appropriate, under the Medical Card or DPS.

[email protected]

http://www.imt.ie/news/latest-news/2016/02/funding-for-fertility-treatments-due.html

The Government’s decision to fund infertility treatment will relieve some of the pressure on women who already face a hugely stressful and emotional journey, a leading support group has claimed.

Health Minister Leo Varadkar has confirmed his intention to provide public funding for assisted reproductive treatment in conjunction with the planned introduction of legislation saying fertility treatments should be funded in such a way “that not only maximises efficiency but which ensures equity of access as well”.

A review of international public funding models is to be carried out and it is hoped the legislation could be in place by the end of 2016 or early next year.

Dr Cathy Allen, consultant obstetrician and gynaecologist at the Merrion Fertility clinic at the National Maternity Hospital welcomed the news. She said about one in six couples will need help. “They will experience some sort of a delay in conceiving when they want to,” she said. “For many of them a visit to their primary care physician GP can be extremely helpful, sometimes its a lifestyle adjustment that needs to be done. For people who are referred on for more expert help to secondary level fertility clinics in hospital or tertiary level assisted reproductive medicine units, about half of those will be referred on for in vitro fertilisation.”

While the Government has not provided final details of how the scheme will operate and be funded, it is likely to be consider factors such as the age of the mother and number of treatments of IVF treatments it is willing to pay for.

Dr Allen told the Anton Savage Show on Today FM: “If you are looking at an economic model, I think the Government will have to considering funding, possibly certain in categories up to three cycles to give people a fair crack of the whip.” She confirmed the treatment is expensive, about €4,000 per cycle.

“That is fresh creation of embryos,” she said. “But some couples will be lucky and they might make three or four or even five embryos. So we put back one and cryo-preserve or freeze the other ones for the future. Once they are safely in the cryo-preservation, that is not quite so expensive and they can remain there.”

Dr John Waterstone, President of the Irish Fertility Society and medical director of the Waterstone Clinic said: “My hope is that whatever funding arrangements are made are comprehensive, and I would particularly hope that they provide for the area of pre-implantation genetic diagnosis. This treatment is used for couples at genetic risk, who are endeavouring, in a proactive way, to prevent transmitting life limiting conditions to their children.”

Helen Browne, co-founder of the National Infertility Support and Information Group, said going for fertility treatment is a stressful and emotional journey for women.

“Having funding will relieve some of that stress,” she said. She pointed out that, prior to the economic crash, some women could afford to pay privately for one cycle of IVF treatment and, if a second was required which was the case in more than half of cases, they would maybe seek help from relatives.

She said after the crash, that was all gone. While some were left with no treatment option because of the cost, others were forced to travel to other countries, such as the Czech Republic, to seek treatment as it was as much as 50% cheaper.

By Stephen Rogers

http://www.irishexaminer.com/ireland/states-fertility-care-plan-to-relieve-pressure-379421.html

Fertility treatments for couples who are finding it difficult to have a baby naturally are to be publicly funded under new proposals to be announced by Health Minister Leo Varadkar today.